中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (45): 8516-8520.doi: 10.3969/j.issn.1673-8225.2010.45.037

• 干细胞临床实践 clinical practice of stem cells • 上一篇    下一篇

自体骨髓间充质干细胞移植治疗早期股骨头缺血性坏死44例

朱  兵1，孙天胜1，周  俊2，姚建华1，吴  军1，常红星1，任大江1   

  1. 解放军北京军区总医院，1全军创伤骨科研究所，  2输血科，北京市    100700
  • 出版日期:2010-11-05 发布日期:2010-11-05
  • 通讯作者: 孙天胜，硕士，主任医师，教授，解放军北京军区总医院骨科，北京市 100700 suntiansheng-@163.com
  • 作者简介:朱兵★，男，1965年生，北京市人，汉族，1993年军医进修学院毕业，硕士，副主任医师，主要从事股骨头骨坏死、骨与软组织肿瘤、骨关节病研究。 orclin@sina.com
  • 基金资助:

    北京市首发基金(2005-3043)。

Autologous bone marrow mesenchymal stem cells transplantation for early avascular necrosis of the femoral head in 44 cases

Zhu Bing1, Sun Tian-sheng1, Zhou Jun2, Yao Jian-hua1, Wu Jun1, Chang Hong-xing1, Ren Da-jiang1   

  1. 1 Institute of Traumatology and Orthropedics, 2 Department of Blood Transfusion, General Hospital of Beijing Military Area Command of Chinese PLA, Beijing  100700, China
  • Online:2010-11-05 Published:2010-11-05
  • Contact: Sun Tian-sheng, Master, Chief physician, Professor, Institute of Traumatology and Orthropedics, General Hospital of Beijing Military Area Command of Chinese PLA, Beijing 100700, China suntiansheng-@163.com
  • About author:Zhu Bing★, Master, Associate chief physician, Institute of Traumatology and Orthropedics, General Hospital of Beijing Military Area Command of Chinese PLA, Beijing 100700, China orclin@sina.com
  • Supported by:

    the Capital Medical Development Foundation Program of China, No. 2005-3043*

PDF

353

被引次数

7

摘要：

背景：股骨头缺血性坏死患者股骨头内间充质干细胞数量减少，成骨分化能力降低是不能实现有效自身修复的细胞病理原因，坏死区周围的硬化带阻碍了骨修复的实现。对于早期股骨头缺血性坏死，自体骨髓间充质干细胞移植结合髓芯减压改善坏死区的血运及促进骨修复的治疗结果分析尚缺乏系统报告。
目的：根据随访结果分析自体骨髓间充质干细胞移植结合髓芯减压治疗早期股骨头缺血性坏死的效果。
方法：2005-05/2008-09共治疗早期股骨头缺血性坏死患者44例，所有接受细胞移植股骨头坏死均为ARCO1或2期，共76髋。采用浓缩自体骨髓细胞悬液回注坏死股骨头内并结合髓芯减压，剩余骨髓血洗涤回输。其中ARCO1期患者仅行干细胞悬液注射，ARCO2期患者移植后行髓芯减压，以Harris评分评价髋关节功能状态。
结果与结论：至2009-03，共随访(22.3±4.2)个月。至随访终期，66髋较细胞移植前疼痛缓解或无明显进展，功能改善，占86.9%；10髋疼痛加重，ARCO分期进展至3或4期，其中3髋行人工关节置换。提示自体骨髓间充质干细胞移植结合髓芯减压是治疗早期股骨头缺血性坏死的有效方法，在早期股骨头缺血性坏死的各种治疗方法中，与其他减压及手术方法相比更符合针对病因的治疗，进一步扩大应用有可能获得更佳的临床效果。

关键词: 髓芯减压, 骨髓间充质干细胞, 细胞移植, 股骨头缺血性坏死, 随访

Abstract:

BACKGROUND: Avascular necrosis of the femoral head (ANFH) is deficient in mesenchymal stem cells and their function for osteogenesis is lower than normal. The sclerotic bands affect bone repair. It is necessary that detailed result analysis of autologous bone marrow mesenchymal stem cells transplantation with core decompression that can improve blood transport and contribute to bone repair to early stage of ANFH.
OBJECTIVE: To analyze results of follow up for early ANFH after autologous bone marrow mesenchymal stem cells transplantation and core decompression.
METHODS: From May 2005 to September 2008, forty-four patients with early ANFH were enrolled. All 76 hips were in the stage of 1-2 of ARCO staging system. All enrolled patients received concentrated autologous bone marrow stem cell injection and combined core decompression. ARCO1 patients were subjected to stem cell suspension injection, and ARCO2 patients were subjected to core decompression following transplantation. Harris scoring was used to evaluate the outcomes.
RESULTS AND CONCLUSION: Till March 2009, follow up was performed (22.3±4.2) months. Pain relief and function improved in 66 hips (86.9%); another 10 hips collapsed to stage 3-4 and total hip arthroplasty was performed in 3 cases. Results indicate that it is an effective and simple procedure for early ANFH using autologous bone marrow mesenchymal stem cells transplantation and core decompression. According to cytopathology of ANFH, our method is more reasonable than other procedures. Better clinical results would be achievable when carrying out in larger scale.

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